Outcomes of SARS-CoV-2 and Seasonal Viruses Among Children Hospitalized in Brazil

• Published in: Pediatrics (Evanston) 2024-01, Vol.153 (2)
• Main Authors: Dias, Cristiane S, Diniz, Lilian M, Oliveira, Maria Christina L, Simões E Silva, Ana Cristina, Colosimo, Enrico A, Mak, Robert H, Pinhati, Clara C, Galante, Stella C, Veloso, Isadora Y, Martelli-Júnior, Hercílio, Oliveira, Eduardo A
• Format: Article
• Language: English
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2023-064326

Understanding how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interacts with other respiratory viruses is crucial for developing effective public health strategies in the postpandemic era. This study aimed to compare the outcomes of SARS-CoV-2 and seasonal viruses in children and adolescents hospitalized with severe acute respiratory infection (SARI). This population-based, retrospective cohort study included children and adolescents hospitalized with SARI from February 2020 to February 2023 in Brazil. The main exposure of interest was viral etiology. The primary outcome was in-hospital mortality. Competing risk analysis was used to account for time dependency and competing events. A total of 235 829 patients had available results of the viral tests, with SARS-CoV-2 predominance. According to the competing-risk survival analysis, the estimated probability of a fatal outcome at 30 days of hospitalization according to the viral strain was 6.5%, 3.4%, 2.9%, 2.3%, 2.1%, and 1.8%, for SARS-CoV-2, coinfection, adenovirus, influenza, other viruses, and respiratory syncytial virus, respectively. Individuals with a positive test for SARS-CoV-2 had hazard of death 3 times higher than subjects with a negative test (hazard ratio, 3.3; 95% confidence interval, 3.1-3.5). After adjustment by the competing-risk multivariable analysis, admission in Northeast and North regions, oxygen saturation